Defibrillator Saves 1st Life Aboard A U.s. Plane

February 20, 1998|By John Crewdson, Tribune Staff Writer.

If Robert Giggey had chosen another airline for his Mexican vacation, he would very likely still be dead. Instead Giggey, a 53-year-old North Carolina businessman, Wednesday became the first person to be revived after experiencing cardiac arrest aboard a U.S. airliner.

Following a brisk walk to the gate, Giggey and his wife, Carmen, had just taken their seats aboard an American Airlines flight from Dallas-Ft. Worth Airport to Mexico City when Carmen Giggey turned to speak to her husband.

"He was sitting by the window," she said. "We were buckled and ready to go. I turned my head and said, `Honey,' and he didn't respond. His eyes were dead--just dead. His skin was clammy. His teeth were clenched. Nothing moved, no response. I never saw anything like that before. I must have screamed for help.

"The next thing I knew the stewards were all around me, two stewards and a stewardess. They just zoomed in. They got me out of the way and got to him. He had no pulse, no heartbeat. They had this thing they called a defibrillator. I didn't know what a defibrillator was."

Fortunately for Robert Giggey, who had suffered sudden cardiac death, American carries battery-powered defibrillators, making it the only U.S. airline that currently does. The machines can restore a normal heartbeat in cases of cardiac arrest by delivering a strong electric shock.

"He was still in his seat, leaning over with his head in the aisle," Carmen Giggey recalled Thursday. "My husband's a big man--he's 6-feet-4. We call him `Big Gig.' They pulled his shirt apart, they cut his T-shirt out of the way and they hooked up their machine."

The defibrillator used by American, a portable model called the Heartstream ForeRunner, read Giggey's heart rhythm and concluded that he was experiencing what Dr. David McKenas, American's corporate medical director, described as "a classic ventricular fibrillation," a condition in which the heartbeat is too rapid and erratic to pump blood to the brain.

"He was by all appearances dead: unconscious, no pulse, no breathing," McKenas said.

Carmen Giggey stood by and watched. "I just kept saying, `Please God, give me my husband back,' " she recalled. "Then one of the stewards said, `He's going to be all right.' It was a wonderful thing. For a few seconds I was a widow."

According to the ForeRunner's internal computer, Giggey's heart rhythm returned to normal less than 20 seconds after the defibrillator's electrodes were attached to his chest. "Just one shock was all it took because they got to him so fast," McKenas said. "The captain said it was very, very dramatic."

American declined to make any of the flight attendants involved in the resuscitation available to reporters. But the account provided by one of the attendants to a Heartstream executive credited the role of an off-duty paramedic from the Garland, Texas, Fire Department, who was also a passenger.

"She said the paramedic answered the call for medical assistance," said the executive, who asked not to be named. "The paramedic started CPR and mouth-to-mouth resuscitation while (the attendant) ran to get the defibrillator. When she got back they reversed roles . . . and the paramedic attached the electrodes and delivered the shock."

The paramedic, who remained on the flight to Mexico City, could not be located immediately. According to American officials, the flight attendant recently had been trained to operate the defibrillator in the absence of medical assistance. The airline says all 20,000 of its flight attendants will be given such training.

In cases of cardiac arrest, the chance of survival drops by about 10 percent with each passing minute. Unless defibrillation occurs within the first 10 minutes, it is not likely to be successful.

"The key is that the defibrillator got there early," said Dr. Ted Bronson, a cardiologist at the Baylor Medical Center in Irving, Texas, where Giggey's condition was described as serious but stable. "Even in the hospital it usually takes several shocks with someone of his size."

Although airport paramedics equipped with a defibrillator also responded, according to Capt. Mike Simpson, a paramedic supervisor at the Dallas-Ft. Worth Airport, they did not receive the call until some eight minutes after Giggey had been revived.

The paramedics boarded the plane and administered cardiac-stabilizing drugs before transporting Giggey to a waiting ambulance.

Airlines are not required to carry such drugs in their on-board medical kits, but American has announced plans to begin adding them in April, along with medications to treat other acute illnesses and several pieces of hospital-style emergency equipment used in cardiac emergencies.

According to Bronson, hospital tests showed Giggey was suffering from a blockage of his coronary arteries that impeded the flow of blood to his heart. Bronson said the condition probably had been exacerbated by the Giggeys' haste, which then caused his heart to begin fibrillating.